What filler do I need for extreme loss of facial fat? (photos)

Although there is no one absolute best choice for you, there are a few good options.  As you are in your 20's, a long term improvement would be advantageous.  Your own fat offers the best chance at permanent replacement fullness.  This is a surgical procedure, either performed in the office under local anesthesia or in a surgery center under IV sedation, with the fat being harvested from an area such as the abdomen or thighs, refined, and then injected into the appropriate facial areas.  Since only about 70% of transplanted fat survives on average, patients often end up having a second treatment in the future.  The fat that does survive will be permanent, as it is your own tissue.  Interestingly, if you gain a lot of weight in the future, that fat may visibly increase in size!  On the other hand, the "off the shelf" fillers such as Voluma or Radiesse seem to last between 1 and 2 years.  Sculptra can last up to 2 years with a touch up along the way, and is a different type of filler in that it stimulates your body to produce its own collagen, thus thickening the skin and soft tissue.  Depending on the exact area of the face and the extent of atrophy, I might choose from any of the above, but keep in mind that only fat has the potential to be permanent.

Sculptra is a great option as it builds collagen which will last about two years. The treatment is generally done in 2-3 sessions spaced 6-8 weeks apart until the result is achieved. From there, you can maintain with yearly treatments. Each treatment is around $3500.Fat transfer is also an option which would be a little more permanent. Liposuction is performed to the abdomen or thighs, and the fat is injected into the face. This is usually done in the operating room, but it can sometimes be tolerated under local anesthesia in the office. Generally 50-70% of the fat survives, so some people desire a second treatment a few months later to enhance the result. The cost is around $3000-5000. Voluma is a new filler from the makers of Juvederm, and it can be used in those areas. It is around $800-1000 a syringe (you'd probably need 2-4), and it lasts up to 2 years. Best of luck achieving the result you want.

Typically for loss of volume in the submalar region Scuptra is a good choice.  You can also use fat grafting.  Both methods will take more than one treatment to achieve significant results.

There are many options for treatment for this.  My favorite fillers here are fat injections, Radiesse and/or Sculptra (often in combination), Voluma, or Silikon.  My suggestion is seeing a filler injector with extensive experience in treating men with this type of facial contour irregularity.  I have patients fly from all over for this type of treatment.  One injection, one syringe, one appointment will not give you a long term improvement.  You need to find a physician who will have a cosmetic treatment plan for you and work to get you to your ultimate result over time.  The results will be better and longer lasting than if you try and do it all in one treatment (which is expensive too).  Best, Dr. Emer.

Hi Franchi.  Whatever filler you use, it's going to be a bit of a project because you have very sunken cheeks.  Radiesse is an excellent product, but the skill of the injector will certainly determine how happy you are with the outcome.  If you are not happy with the Radiesse, you may consider Sculptra injections.  The product may be more expensive, but it is very natural looking and lasts longer because it is your own collagen.  Good luck.

The photos show a face with a significant depletion of volume.  I would first rule out any organic causes for this facial fat depletion.  The next course of action would be to consult with an experienced injector about the possibility of having Sculptra (a gradual bio-stimulator of facial collagen) or Voluma ( a thick form of hyaluronic acid gel).  You would  most likely require at least three sessions of Sculptra or 6 syringes of Voluma to significantly improve the facial volume depletion.

You are an ideal candidate for fat injection.Sculptra is great, but your problem is too big for Sculptra ( used it for a decade)Your problem is too big for fillers like traditional 1cc at a time treatments. You could benefit from around 20 to 30 cc of fat volume in your face. Go figure have much that amount of traditional filler would cost.If a practitioner only can offer you one option, that is what you would receive. "When you have a hammer, all the world looks like a nail" Please avoid pseudo practitioners who may legally be allowed to inject your face. Your issue is not like a little case of someone who wants a little 1cc of filler in her nasolabial fold a couple times a year.Be treated by a Real Board Certified Plastic Surgeon experienced in fat grafting.

I
think you are a great candidate for Sculptra injections. Sculptra is indicated
for lipoatrophy or loss of fat. It contains particles of poly-L-lactid acid
that are suspended in water. When they are injected under the skin they
stimulate collagen production which lasts about 2 years.These injections do require some commitment and
patience. The product is injected every 4-6 weeks and you may require at least
4 sessions to achieve desirable effect. The body starts to produce collagen at
about 4 weeks after the first injection and you continue to see improvement for
6 months to a year.

Given the global amount of volume loss, Scuptra would be a good consideration. See a board certified dermatologist or plastic surgeon who has training in Sculptra.

I agree that Sculptra and Voluma are good choices for improving your volume loss.  I also noticed in your photo that you have significant acne scarring.  This also can be improved with subcision and laser resurfacing.